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General NPI Number Information
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NPI Number | 1952317505
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Entity Type | Individual
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Provider Name | SCOTT D BENNION M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 2546 E 2ND ST STE 400
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City | CASPER
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State | WY
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Zip | 82609-2062
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Country | US
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Telephone | 307-234-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 2546 E 2ND ST STE 400
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City | CASPER
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State | WY
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Zip | 82609-2062
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Country | US
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Telephone | 307-234-0003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 34844
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 3201A
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License Number State | WY
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